Using the Personalized Advantage Index for Individual Treatment Allocation to Blended Treatment or Treatment as Usual for Depression in Secondary Care

Friedl, Nadine; Krieger, Tobias; Chevreul, Karine; Hazo, Jean Baptiste; Holtzmann, Jérôme; Hoogendoorn, Mark; Kleiboer, Annet; Mathiasen, Kim; Urech, Antoine; Riper, Heleen; Berger, Thomas (2020). Using the Personalized Advantage Index for Individual Treatment Allocation to Blended Treatment or Treatment as Usual for Depression in Secondary Care. Journal of clinical medicine, 9(2) MDPI 10.3390/jcm9020490

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A variety of effective psychotherapies for depression are available, but patients who suffer from depression vary in their treatment response. Combining face‐to‐face therapies with internet‐ based elements in the sense of blended treatment is a new approach to treatment for depression. The goal of this study was to answer the following research questions: (1) What are the most important predictors determining optimal treatment allocation to treatment as usual or blended treatment? and (2) Would model‐determined treatment allocation using this predictive information and the personalized advantage index (PAI)‐approach result in better treatment outcomes? Bayesian model averaging (BMA) was applied to the data of a randomized controlled trial (RCT) comparing the efficacy of treatment as usual and blended treatment in depressive outpatients. Pre‐ treatment symptomatology and treatment expectancy predicted outcomes irrespective of treatment condition, whereas different prescriptive predictors were found. A PAI of 2.33 PHQ‐9 points was found, meaning that patients who would have received the treatment that is optimal for them would have had a post‐treatment PHQ‐9 score that is two points lower than if they had received the treatment that is suboptimal for them. For 29% of the sample, the PAI was five or greater, which means that a substantial difference between the two treatments was predicted. The use of the PAI approach for clinical practice must be further confirmed in prospective research; the current study supports the identification of specific interventions favorable for specific patients.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy

UniBE Contributor:

Friedl, Nadine; Krieger, Tobias; Urech, Antoine and Berger, Thomas


600 Technology > 610 Medicine & health
100 Philosophy > 150 Psychology








Melanie Best

Date Deposited:

18 Feb 2020 11:34

Last Modified:

30 Mar 2020 14:34

Publisher DOI:


PubMed ID:





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